How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $14.13 Median $1,380.38 Typical High $5,011.87 | Facility | None | $14.13 | $1,380.38 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $14.13 Median $24.55 Typical High $26.92 | Professional | None | $14.13 | $24.55 | $26.92 |
Anthem BCBS Setting Facility Modifier None Typical Low $19.50 Median $1,000.00 Typical High $1,621.81 | Facility | None | $19.50 | $1,000.00 | $1,621.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.00 Median $24.55 Typical High $38.90 | Professional | None | $10.00 | $24.55 | $38.90 |
CareSource Setting Facility Modifier None Typical Low $17.38 Median $616.60 Typical High $912.01 | Facility | None | $17.38 | $616.60 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $18.20 Median $28.84 Typical High $2,691.53 | Facility | None | $18.20 | $28.84 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $18.20 Median $26.92 Typical High $67.61 | Professional | None | $18.20 | $26.92 | $67.61 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $41.69 Median $89.13 Typical High $2,187.76 | Facility | None | $41.69 | $89.13 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $18.62 Median $29.51 Typical High $41.69 | Professional | None | $18.62 | $29.51 | $41.69 |
United Setting Facility Modifier None Typical Low $109.65 Median $812.83 Typical High $4,168.69 | Facility | None | $109.65 | $812.83 | $4,168.69 |
United Setting Professional Modifier None Typical Low $15.85 Median $30.90 Typical High $58.88 | Professional | None | $15.85 | $30.90 | $58.88 |
5 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $7.08 Median $12.30 Typical High $13.49 | Professional | 52 · Reduced service | $7.08 | $12.30 | $13.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.82 Median $4.90 Typical High $5.37 | Professional | 53 · Discontinued | $2.82 | $4.90 | $5.37 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $10.47 Median $18.20 Typical High $20.42 | Professional | 54 · Surgery only | $10.47 | $18.20 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.09 Median $3.63 Typical High $4.07 | Professional | 55 · Aftercare only | $2.09 | $3.63 | $4.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.41 Median $2.45 Typical High $2.69 | Professional | 56 · Pre-op care only | $1.41 | $2.45 | $2.69 |
Where Indiana sits
The same service costs 3.9 times more in Alaska than in Hawaii. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Indiana· 50th of 51
$25.12
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.